Total Quality Management for Cold Chain: A-SMART and 5C method

12 April 2019

quality control

In an article on cold chain vaccine delivery, Matthias, D.M. (et al)* state that in developing countries 22% of the healthcare cold chain products are prone to damage during storage. Although Asia is developing, it is yet to be fully matured in various aspects, especially when it comes to cold chain management. As introduced in the previous article, to address the challenges many companies face in cold chain management, DKSH has developed a unique, research-based program called the “Total Quality Management (TQM) for Cold Chain”.

The TQM for Cold Chain program is made up of two unique building blocks: the A-SMART method and the 5C method.


A-SMART stands for “Assimilated Strategic Method for Asset Review and Targeting”. It is our strategic asset management method, which combines the review of total cost of ownership (TCO) and life cycle management (LCM).

2. 5C

The 5Cs are:

  • Condition – focuses on asset condition
  • Control – focuses on checking, recording and analysis
  • Competence – focuses on vendor capabilities
  • Contingency – focuses on event readiness
  • Culture – focuses on internal organization

The 5Cs are proactive, systemic and interwoven. They represent a holistic approach to managing the quality of the cold chain, dealing with challenges and inconsistencies and ensuring they are promptly and efficiently addressed to ensure the cold chain is never broken. These 5Cs are clearly driven by insights and integrity, driving measures for improvement. Managing the 5Cs requires the involvement of all internal stakeholders at different levels in a structured manner.

The 5C method comprises specific trainings, including various tests and evaluations. Furthermore, a structured approach regarding asset reviews takes place at several levels and in various ways through monthly reporting, regional internal cross-auditing and unannounced visits. These evaluations are part of staff performance reviews, and link into the A-SMART method.

From a “Risk Management Maturity Model” ** perspective, the development and implementation of these unique methods has helped DKSH transition from an operational-contingency focused organization to a systemic, strategic and tactical organization. To achieve this transformation, specific trainings have been developed and implemented.

Finally, our people are of key importance in ensuring that the 5Cs are implemented and their integrity and diligence plays a big part in identifying opportunities for further enhancement. Because of their commitment and inputs, we know which spare parts we need to replace proactively, as well as which critical spare parts we need to keep on site permanently. This has minimized our “downtime” significantly. More importantly, it maximized the product availability for patients. Stay tuned for more on A-SMART and 5C.

Published by Tim Broekhuizen on January 15, 2019



** Oliva, F.L., 2015, pg. 77


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